The primary symptoms of contact granuloma include chronic or acute hoarseness of the voice and vocal fatigue.

[1][5][8] In addition, the presence of the contact granuloma makes it impossible for the vocal folds to come to a complete closure in adduction.

[5] Contact trauma can occur when a person frequently speaks at a pitch that is lower than their modal voice, especially in vocally-demanding professions like acting, teaching and singing.

Contact granulomas can be physically identified and diagnosed by observing the presence of proliferative tissue originating from the vocal process of the arytenoid cartilage.

[5] Identification is carried out by laryngoscopy, which produces an image of the lesion in the form of an abnormal growth (nodule or polyp) or ulceration.

[8] In nodule or polyp form, contact granulomas generally have a grey or dark red colouring[8][5] and measure 2 to 15 mm in size.

[12][8] Microscopic examination of the tissue can help determine that the lesion is benign rather than cancerous, as would be the case in contact granuloma.

[8] Specific treatment for contact granuloma depends on the underlying cause of the condition, but often initially includes a combination of speech therapy,[8][12][13][3] vocal rest,[8][12][13] and antireflux medication.

These more aggressive approaches might be used in the case of the refractory (i.e. resistant to treatment) contact granuloma where previous interventions have not succeeded or recurrence rates are high.

[3] The application of corticosteroids to treat contact granulomas is considered a more extreme approach[8] and its utility remains in contention.

[5] The injection of botulinum neurotoxin A, or Botox, to treat contact granulomas is considered a more extreme approach,[8] and is generally only pursued when the case has been resistant to other treatments.

[5][3] In this approach, Botox is injected into the thyroarytenoid muscle (unilaterally or bilaterally), targeting a reduction in the contact forces of the arytenoids.

[5] Surgery When all other medical and behavioural treatments have been attempted, surgical removal of the contact granuloma is possible as a last resort option.

[3] Most recent research suggests that surgical options should only be explored once treatment of reflux with or without voice therapy has been introduced.

[8] In cases where gastroesophageal reflux disease is identified as the most likely cause of the granuloma, the patient is most commonly an adult man in his 30s or 40s.